Friday, March 2, 2012

Psychiatrists: Put away the prescription pads and bring out the controllers

A new industry has been born — the vast brain training industry, which is only going to increase in market share.

Being a natural skeptic, I am somewhat dubious about the claims that brain training will alleviate the symptoms of schizophrenia, but I applaud any efforts to help people get back onto their feet that don't involve drugs. In my experience, almost any therapy that Chris undertook that didn't involve drugs helped him improve without debilitating side-effects. The brain is not the mind, however, and it's this distinction that may be lost when it comes to helping people overcome schizophrenia through the use of video games. Brain training implies that the person has brain and cognitive deficits, that as far as I know, have not been scîentifically proven when it comes to schizophrenia. Much of schizophrenia has to do with the "soft science" of treating emotional issues.

Michael Merzenich has a plan for how to convince sceptics of the worth of his brain-training video games: prove that the software can help people with schizophrenia.

Erika Check Hayden 29 February 2012

The brain-training industry — which was projected to grow from US$265 million in 2008 to between $1 billion and $5 billion by 2015 — markets games that claim to boost skills such as memory or focus in healthy adults. But for those likely to need it most, such as elderly people, there has been no convincing evidence that the games work any better than the mostly free activities that physicians routinely recommend, such as physical exercise, socializing with friends, taking up a new hobby or playing a musical instrument. “Really well-designed clinical trials to test the efficacy of these devices are few and far between. It's sort of like the Wild West,” says Peter Snyder, a neurologist at Brown University's Alpert Medical School in Providence, Rhode Island.

Merzenich, however, feels that he has fought long enough to prove the validity of brain training. Now, he says, it is time for regulators to weigh in. Treating schizophrenia with software would mark a change for psychiatry, which tends to focus on dispensing drugs in the first instance. Vinogradov says that the growing realization of drugs' shortcomings and a shift away from the idea that brain deficits are immutable are sparking desire for alternative options.

“The dominant force in psychiatry has been the focus on treating symptoms, not the underlying dysfunction. The patient is this passive object to whom you give pills, as opposed to actively helping to stimulate constructive interaction with his or her environment,” Vinogradov says.

And Merzenich doesn't plan to stop with schizophrenia. The Brain Plasticity Institute in San Francisco, another Merzenich-founded company, is studying brain-training software for conditions ranging from Alzheimer's disease to traumatic brain injury. “If we do this in a disciplined way, with scientific confirmation that is beyond question,” Merzenich says, “we'll very rapidly evolve into a very important aspect of psychiatric medicine.”

This could be your new relationship with your psychiatrist.
scene from The 40 Year Old Virgin